Surrogate markers for survival in patients with AIDS and AIDS related complex treated with zidovudine.
Surrogate markers for survival in patients with AIDS and AIDS related complex treated with zidovudine.
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用齐多夫定治疗的艾滋病和艾滋病相关综合症患者的生存替代标记。
DOI：
10.1136/bmj.302.6768.73
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
Wilber,J
中科院分区：
文献类型：
--
作者：
Jacobson,MA;Bacchetti,P;Kolokathis,A;Chaisson,RE;Szabo,S;Polsky,B;Valainis,GT;Mildvan,D;Abrams,D;Wilber,J
为了确定齐多夫定治疗对CD 4+淋巴细胞计数和β 2微球蛋白、新蝶呤、HIV p24抗原或抗体与AIDS或AIDS相关综合征患者的生存率相关。回顾性研究实验室标志物的变化和生存率。齐多夫定200毫克，口服，每4小时一次。56例患者在开始齐多夫定治疗后平均17个月死亡，其余34例患者平均随访25.5个月。采用多变量比例分析法确定独立预测不良生存率的治疗前特征。危险模型：诊断为AIDS（v AIDS相关综合征），年龄超过45岁，以及血清新蝶呤浓度的对数。当控制这些基线特征时，治疗第8-12周的CD 4+淋巴细胞计数对数（p = 0.007）和第8-12周的血清β 2微球蛋白浓度增加（p = 0.05）也与生存独立相关。在38例治疗前预后较好的患者中，早期治疗期间对两种替代标志物反应良好的患者的24个月生存率由乘积极限法估计为88%，而对任一标志物反应不良的患者的24个月生存率仅为50%。在38个治疗前预后较差的患者中，24个月的生存率估计为49%，而对两种替代标志物反应良好的患者仅为18%，而对任何一种反应不良的患者仅为18%。血清β 2微球蛋白浓度的变化可能是HIV患者抗逆转录病毒药物临床试验结果的替代终点。
OBJECTIVETo determine whether early effects of zidovudine treatment on CD4+ lymphocyte count and concentrations of beta 2 microglobulin, neopterin, or HIV p24 antigen or antibody are correlated with survival in patients with AIDS or AIDS related complex.DESIGNRetrospective study of changes in laboratory markers and survival.SETTINGMulticentre trial at university hospital clinics.SUBJECTS90 Patients with AIDS or AIDS related complex.INTERVENTIONPatients started zidovudine 200 mg orally every four hours. Fifty six of the patients died a median 17 months after starting zidovudine; the remaining 34 patients were followed up for a median 25.5 months.MAIN OUTCOME MEASURESChanges in CD4+ lymphocyte count and serum concentrations of p24 antigen and antibody, beta 2 microglobulin, and neopterin; survival of the patient.RESULTSThe pretreatment characteristics that independently predicted poor survival were determined using a multivariate proportional hazards model: a diagnosis of AIDS (v AIDS related complex), age over 45 years, and the logarithm of serum neopterin concentration. When these baseline characteristics were controlled for the logarithm of CD4+ lymphocyte count at weeks 8-12 of treatment (p = 0.007) and an increase in serum beta 2 microglobulin concentration at weeks 8-12 (p = 0.05) also independently correlated with survival. In the 38 patients with a better pretreatment prognosis, 24 month survival estimated by the product-limit method was 88% for those with a good response on both surrogate markers during early treatment compared with only 50% for those with a poor response on either marker. In the 38 with a worse pretreatment prognosis, 24 month survival was estimated to be 49% for those with a good response on both surrogate markers compared with only 18% for those with a poor response on either.CONCLUSIONThese data suggest that CD4+ lymphocyte count at 8-12 weeks and, perhaps, change in serum beta 2 microglobulin concentration could be surrogate end points for clinical outcome in trials of antiretroviral drugs for patients with HIV disease.
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影响因子：
158.5
作者：
GOEDERT, JJ;KESSLER, CM;GAIL, MH
通讯作者：
GAIL, MH
影响因子：
158.5
作者：
FAHEY, JL;TAYLOR, JMG;GIORGI, JV
通讯作者：
GIORGI, JV
HIV 血清阳性和艾滋病或艾滋病相关病症的发展：旧金山总医院队列的三年随访
DOI：
10.1136/bmj.296.6624.745
发表时间：
1988
期刊：
British Medical Journal (Clinical research ed.)
影响因子：
--
作者：
A. Moss;P. Bacchetti;D. Osmond;W. Krampf;R. Chaisson;D. Stites;J. Wilber;J. Allain;James Carlson
通讯作者：
James Carlson
齐多夫定对血清人类免疫缺陷病毒核心抗原水平的影响。
影响因子：
--
作者：
R. E. Chaisson;M. Leuther;Jean;S. Nusinoff;Gloria S. Boone;David W. Feigal;P. Volberding
通讯作者：
P. Volberding
影响因子：
158.5
作者：
HO, DD;MOUDGIL, T;ALAM, M
通讯作者：
ALAM, M